NEW ORLEANS– As the effectiveness of anesthesia, pain management and rehabilitation continues to improve, more orthopaedic procedures are being done on an outpatient basis. In a new research study presented today at the 2014 Annual Meeting of the American Academy of Orthopaedic Surgeons(AAOS), same-day total joint replacement (TJR) patient outcomes were comparable to those of patients admitted to the hospital and staying at least one night following surgery. However, readmission rates, although statistically “non-significant,” were higher for outpatient procedures. In a related study, a very low complication rate (.23 percent) was found in a review of more than 28,737 hand and upper extremity surgeries at an outpatient specialty clinic.
Many surgeons are now performing TJR as a same day procedure, with patients discharged within 24 hours of surgery. Outpatient TJR has “the potential benefit to cut costs and improve patient satisfaction,” however, concerns for patient recovery, as well as increased Medicare scrutiny and financial penalties for unplanned hospital readmissions within 30 days of surgery, is deterring some doctors and hospitals from routinely performing outpatient surgeries, said David N. Vegari, MD, a Philadelphia orthopaedic surgeon and lead author of the study, “Implications of Outpatient vs. Inpatient Total Joint Arthroplasty on Hospital Readmission Rates.”